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Marcotte LM, Reddy A, Liao J. Addressing Avoidable Healthcare Costs: Time to Cool Off on Hotspotting in Primary Care?. Journal of general internal medicine. 2019 Nov 1; 34(11):2634-2636.
One increasingly popular strategy for addressing avoidable healthcare costs is to couple "hotspotting" with interventions that deliver expanded, more intense primary care services to high-cost patient populations. While there is rationale for such intensive primary care programs, early results have been lackluster. Geoffrey Rose's preventive medicine strategy provides insight about a potential explanation: that the narrow scope of these initiatives on small groups of high-cost patients may inherently prevent them from achieving overall cost reductions across entire patient populations. While additional work and results from innovative non-healthcare-based interventions are needed, healthcare organizations may benefit from instead investing in broader interventions that impact patients across cost levels, including average- or low-cost patients.